扩散加权成像体素内不相干运动模型参数与乳腺癌预后因素及分子亚型的相关性

Correlation of diffusion weighted imaging intravoxel incoherent motion model with prognostic factors and subtypes of breast cancers

目的探讨DWI体素内不相干运动(IVIM)模型参数与乳腺癌预后因素及分子亚型的相关性。方法收集经病理证实的110例乳腺癌患者,所有患者在手术或穿刺活检前均行多b值DWI扫描。采用GE后处理工作站生成IVIM模型参数D、D*和f值,分析各参数与预后因素及分子亚型间的相关性。结果高侵袭性病灶D值低于低侵袭性者(P<0.01),f值高于低侵袭性者(P<0.01)。孕激素受体(PR)阳性病灶的D值低于阴性者(P=0.042)。人类表皮生长因子受体(HER-2)高表达病灶的D和D*值均高于低表达者(P=0.001、0.033);HER-2高表达型病灶的D值明显高于Luminal型和三阴性型(P均<0.05)。D值与病理分级、PR表达呈负相关(r=-0.535、-0.192,P均<0.05),与HER-2表达呈正相关(r=0.304,P=0.001);D*值与HER-2表达呈正相关(r=0.200,P=0.033)。结论 DWI的IVIM模型参数与乳腺癌的病理分级、PR及HER-2表达存在相关性,D值具有鉴别不同分子亚型乳腺癌的潜在价值。

Objective To explore the correlation of intravoxel incoherent motion（IVIM）model parameter with prognostic factors and subtypes of breast cancers.Methods Totally 110 patients with histologically confirmed breast cancer were collected.All of them were examined with multiple-b value DWI before surgery and biopsy.GE workstation was used to calculate the value of D,D^＊and f deriving from IVIM model.Correlation between IVIM parameters and prognostic factors and molecular subtypes was analyzed.Results D value of the highly aggressive lesions was significantly lower than that of low aggressive lesions（P〈0.01）,while f value was significantly higher than that of low aggressive lesions（P〈0.01）.D value of progesterone receptor（PR）-positive lesions were significantly lower than that of PR-negative ones（P=0.042）.D and D^＊value of human epidermal growth factor receptor 2（HER-2）-positive lesions were significantly higher than that of HER-2-negative ones（P=0.001,0.033）.D value of HER-2-enriched tumor was significantly higher than that of luminal and triple-negative tumors（both P〈0.05）.D value was negtive correlated with pathological grade and PR expression（r=-0.535,-0.192,both P〈0.05）,and positive correlated with HER-2expression（r=0.304,P=0.001）;D^＊value was pasitive correlated with HER-2expression（r=0.200,P=0.033）.Conclusion IVIM parameters of DWI are correlated with pathologic degree,PR and HER-2expression of breast cancer.There is potential value for D to distinguishing different subtypes.